Pediatric Anesthesia Neurotoxicity: An Overview of the 2011 SmartTots Panel

Through the years, care of millions of premature infants and young children has resulted in numerous exposures to a variety of anesthetic and sedative agents. These agents, designed to achieve the substantial depth of neuronal inhibition required for complete loss of consciousness and insensitivity to pain, are often a necessary component of successful treatment. However, data collected in animal models over the past decade suggest that general anesthetics damage developing neurons. Emerging animal and human data also suggest an association between early exposure to general anesthesia and long-term impairment of cognitive development. Consequently, the prudence of administering anesthesia to this population is now being scrutinized. Because general anesthesia cannot often be avoided when young children are diagnosed with conditions requiring surgery, or undergo time in intensive care units, the scientific community is focused on gaining a thorough understanding of the mechanisms of action so that we may take full advantage of the beneficial effects of anesthetics and sedatives without potentially devastating neurotoxic outcomes.

A distinctive panel of speakers convened during SmartTots: Pediatric Anesthesia Neurotoxicity, a session at the 2011 International Anesthesia Research Society Annual Meeting, to provide an overview of 2 important lines of research. One focused on improving our knowledge of the cellular mechanisms operational in anesthetic-induced developmental neurotoxicity, and another focused on advancing our understanding of anesthesia-related neurobehavioral sequelae in mammalian species exposed to anesthesia during critical stages of brain development.